Endoscopic Devices

Abstract

To provide an endoscope device that allows adjustment of a retractor at the time of treatment to be executed without depending on fastening and loosening of a fastening member, and allows the treatment to be executed smoothly.SOLUTION: In a state that the other end sides of support arms 31 and 32 are fastened so as to be held inseparably in a state that each of support seat faces 34 can slide around the center for a spherical surface part 22, each of the support seat faces 34 is press-fitted in a state that sliding resistance is adjusted for the spherical surface part 22 while imparting elastic force in a direction that they get closer to each other by manually fastening and loosening a coil spring 45. A protrusion 51 of a cylinder part 21 is engaged in a groove part 53 that becomes shallower as it moves from an insertion direction rear end of a peripheral surface of an insertion hole 23 in a circumferential direction along the insertion hole 23 from a communication position through a concave part 52.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to an endoscopic device that allows an endoscope to be inserted into a body and allows surgery while observing the surgical field, and more particularly to an endoscopic device that secures a cylindrical insertion space inside the body with the cylindrical portion of a retractor. [Background technology]

[0002] In recent years, endoscopic surgery using an endoscopic device has been attracting attention as a minimally invasive treatment for spinal disorders such as herniated discs and spinal stenosis. For example, in Patent Document 1, a small hole is made in the patient's body, and the tubular portion of a retractor is inserted into the hole to ensure the hole is large enough. In this state, surgical instruments such as an endoscope and forceps are inserted into the body through the tubular portion, and the surgical field is observed with the endoscope while the procedure is performed.

[0003] In such an endoscopic device, a spherical portion having a spherical outer peripheral surface is provided on the outer periphery of the tubular portion of the retractor, while a pair of support arms having concave spherical support seats formed in an approximately semicircular arc shape are provided on a support member that supports the tubular portion of the retractor on an operating table or the like, so that the entire circumferential area of ​​the spherical portion is sandwiched between them at one circumferential point via a connecting member such as a hinge.

[0004] The other ends of the support arms that are away from the connecting member are fastened together by fastening members in the direction of separation, thereby creating a locked state in which the support seat surfaces of the support arms are prohibited from sliding on the spherical portion. At this time, by loosening the fastening members, the support seat surfaces of the support arms become slidable around their centers on the spherical portion, allowing the angle of the cylindrical portion to be changed and the retractor to be adjusted. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Publication No. 2018-126235 Summary of the Invention [Problem to be solved by the invention]

[0006] When performing surgery while observing the surgical field with an endoscope, the angle of the tube may be changed to adjust the retractor. In this case, the wider the surgical field, the more times the fastening members must be tightened and loosened during the procedure, making it difficult to perform the procedure smoothly.

[0007] The present invention has been made in consideration of the above points, and an object of the present invention is to provide an endoscopic device that allows adjustment of a retractor during surgery without relying on tightening or loosening of a fastening member, thereby enabling surgery to be performed smoothly. [Means for solving the problem]

[0008] In order to achieve the above object, the present invention provides a retractor having a cylindrical portion that secures a cylindrical insertion space within the body and through which an endoscope and surgical tools are inserted. This retractor The present invention is based on an endoscope device that enables observation of a surgical field deep inside a body through an endoscope. A spherical portion having a spherical outer peripheral surface is provided on the outer periphery of the cylindrical portion of the retractor. Meanwhile, a pair of support arms is provided on a support member that supports the cylindrical portion of the retractor, each having a concave spherical support seat formed in a substantially semicircular arc shape at one end so as to sandwich substantially the entire circumferential area of ​​the spherical portion from one circumferential point via a connecting portion. The support member is further provided with a fastening and holding means that fastens the other ends of the support arms that are away from the connecting portion to each other in the mutually approaching and separating direction, and holds the support seat in a state where it can slide around the center of the spherical portion and cannot be separated, and an elastic crimping means that applies an elastic force to the other ends of the support arms fastened by the fastening and holding means in the mutually approaching direction, and crimps the support seat against the spherical portion in a state where the sliding resistance of the support seat is adjusted. Get There are.

[0009] The fastening and holding means is provided with a screw member that passes through an insertion hole of one of the support arms and has a screw portion at a tip end thereof fastened to the other support arm with a gap between the other ends of the other support arm. Meanwhile, the elastic crimping means is provided with a screw member that is screwed into the screw portion at the base end of the screw member and moves manually from the base end side to the tip end side of the screw member so as to be loosened or fastened, and a spring member that is compressed when the screw member is tightened and attached between the screw member and the other end of the one support arm. Get There are.

[0010] Furthermore, The spherical portion is provided on the outer peripheral surface of an insertion member having an insertion hole through which the tubular portion is inserted, and an engaging means is provided between the rear end position in the insertion direction of the outer peripheral surface of the tubular portion and the rear end position in the insertion direction of the circumferential surface of the insertion hole, for detachably engaging the two while the tubular portion is inserted into the insertion hole. The engaging means is provided with a protrusion protruding from the rear end position in the insertion direction of the circumferential surface of the tubular portion, a recessed portion recessed at the rear end position in the insertion direction of the circumferential surface of the insertion hole and for moving the protrusion from the rear end in the insertion direction in the axial direction of the tubular portion, and a groove recessed from a communication position communicating with the recessed portion along the circumferential surface of the insertion hole and for moving the protrusion in the circumferential direction. In addition, the groove is formed so as to become shallower as it moves away from the communication position with the recessed portion in the circumferential direction. It is characterized by the fact that

[0011] In contrast to this, the engaging means may be provided with a protrusion protruding from the rear end position in the insertion direction of the circumferential surface of the tubular portion, a notch formed by cutting out both circumferential sides of the protrusion in the axial direction from the rear end of the tubular portion in the insertion direction, a bent portion formed by slightly bending the tip of the notch outward in the radial direction, a recess formed in the rear end position in the insertion direction of the circumferential surface of the insertion hole and for moving the protrusion from the rear end in the insertion direction in the axial direction of the tubular portion, a groove formed in the circumferential direction along the circumferential surface of the insertion hole from a communication position communicating with the recess and for moving the protrusion in the circumferential direction, and a bent portion accommodating hole formed in the circumferential surface of the insertion hole at a distance from the recess in the circumferential direction and for accommodating the bent portion sliding in the circumferential direction on the circumferential surface of the insertion hole together with the protrusion moving in the groove portion so as not to be able to move in the circumferential direction.

[0012] The engaging means may also be provided with a protrusion protruding from the peripheral surface of the cylindrical portion at a rear end position in the insertion direction, a recessed portion recessed into the peripheral surface of the insertion hole at a rear end position in the insertion direction and for moving the protrusion from the rear end in the insertion direction in the axial direction of the cylindrical portion, a groove portion recessed in the circumferential direction along the peripheral surface of the insertion hole from a communication position communicating with the recess and for moving the protrusion in the circumferential direction, a protrusion accommodating hole provided at a spaced position from the recess in the groove portion and for accommodating the protrusion so that it cannot move in the circumferential direction, and a climbing portion provided near the recess in the groove portion that is located closer to the recess than the protrusion accommodating hole and for adjusting the depth of the groove portion so that the protrusion can climb over towards the protrusion accommodating hole. [Effects of the Invention]

[0013] As described above, the other ends of the support arms are fastened together in the direction of separation so that the support seat surfaces of the support arms are held in an inseparable state while being slidable around their centers relative to the spherical portion, and in this state, an elastic force is applied by the elastic crimping means in the direction toward each other, so that the support seat surfaces are crimped against the spherical portion in a state in which the sliding resistance is adjusted. As a result, even during treatment, the angle of the tubular portion can be changed simply by sliding the support seat surfaces against the elastic force relative to the spherical portion without loosening the fastening members, making it possible to easily adjust the retractor during treatment and allowing for smooth treatment.

[0014] Furthermore When the other ends of the support arms are fastened together by the screw portion at the tip end of the screw member, an elastic force is applied in the direction of bringing them closer together by a spring member that is compressed by tightening the screw member that is screwed into the screw portion at the base end of the screw member, and the sliding resistance of each support seat surface against the spherical portion can be more easily adjusted by manually tightening or loosening the screw member.

[0015] Furthermore, the protrusion on the outer peripheral surface of the tubular portion is moved by the recess in the axial direction passing through the center of the insertion direction from the rear end in the insertion direction of the peripheral surface of the insertion hole of the insertion member (i.e., the rear end in the insertion direction of the tubular portion inserted into the insertion hole), and the groove, which moves in the circumferential direction along the peripheral surface of the insertion hole from the position communicating with the recess, becomes shallower as it moves away from the recess in the circumferential direction, thereby releasably engaging the two while the tubular portion is inserted into the insertion hole. This allows the tubular portion to be engaged with and disengaged from the insertion hole with a simple configuration, and enables replacement of only the tubular portion, thereby reducing the replacement cost of the retractor.

[0016] In contrast, when the protrusion, which has been moved axially by the recess of the insertion hole, is then moved circumferentially from the communicating position along the groove of the insertion hole, the tip of the bent portion, which slides on the circumferential surface of the insertion hole as the protrusion moves, engages with the bent portion accommodating hole at a position separated from the recess so as to be unable to move circumferentially. This allows the tubular portion to be engaged and disengaged with the insertion hole using a simple configuration, and enables replacement of only the tubular portion, thereby reducing the replacement cost of the retractor.

[0017] Furthermore, the tip of the bent portion is engaged with the bent portion accommodating hole so as to be unable to move in the circumferential direction as the protrusion moves in the circumferential direction, thereby reliably preventing the tubular portion from falling out of the insertion hole.

[0018] Furthermore, when the protrusion of the cylindrical portion is moved further in the circumferential direction from the rear end of the insertion hole in the insertion direction, through the recess, and from the communicating position, overcoming the overhanging portion of the groove, it engages with the protrusion accommodating hole of the spaced-apart position groove, which is spaced further from the recess than the overhanging portion, so as to be unable to move in the circumferential direction. This allows the cylindrical portion to be engaged and disengaged with the insertion hole using a simple configuration, and enables replacement of only the cylindrical portion, thereby reducing the replacement cost of the retractor.

[0019] Furthermore, the protrusion that moves circumferentially in the groove portion overcomes the overhanging portion and engages with the protrusion accommodating hole at the separated position so that it cannot move circumferentially, thereby reliably preventing the tubular portion from falling out of the insertion hole. [Brief explanation of the drawings]

[0020] [Figure 1] 1 is a side view schematically showing a state in which a treatment is performed using an endoscope device according to a first embodiment of the present invention. [Figure 2] 2 is a perspective view of a retractor of the endoscope device of FIG. 1, seen obliquely from the front side. FIG. [Figure 3] 2 is a perspective view of a retractor of the endoscope device of FIG. 1, seen obliquely from above. [Figure 4] 3 is a plan view of the retractor of FIG. 2 seen from above in a state fastened by a fastening holding means. FIG. [Figure 5] 5 is a plan view of the retractor of FIG. 4 viewed from above in a state of being compressed by an elastic compression means. [Figure 6] 3 is a plan view seen from above of the state before the cylindrical portion of the retractor in FIG. 2 is engaged with the insertion member. FIG. [Figure 7] 3 is a side view of the state before the cylindrical portion of the retractor in FIG. 2 is engaged with the insertion member, as viewed from the side. FIG. [Figure 8] 3 is a plan view showing a state after the cylindrical portion of the retractor in FIG. 2 and the insertion member are engaged with each other, as viewed from above. FIG. [Figure 9] 10 is a plan view of a retractor of an endoscope device according to a modified example of the first embodiment, viewed from above in a fastened state by a fastening holding means. FIG. [Figure 10] 10 is an explanatory diagram illustrating an engaged state between a cylindrical portion of a retractor and an insertion member of an endoscopic device according to a second embodiment of the present invention, viewed from above. FIG. [Figure 11] 10A and 10B are exploded perspective views of a retractor of an endoscope device according to a third embodiment of the present invention, in which (a) is a perspective view of a cylindrical portion, and (b) is a perspective view of an insertion member. [Figure 12] 12 is a plan view seen from above of the state before the cylindrical portion of the retractor and the insertion member in FIG. 11 are engaged with each other. FIG. [Figure 13] 12 is a plan view showing the state after the cylindrical portion of the retractor and the insertion member in FIG. 11 are engaged with each other, as seen from above. FIG. [Figure 14] 12 is a side view showing the state after the cylindrical portion of the retractor and the insertion member in FIG. 11 are engaged with each other. FIG. [Figure 15]FIG. 11 is a perspective view of a cylindrical portion of a retractor of an endoscope device according to a modified example of the third embodiment. [Figure 16] 10 is a plan view of a retractor of an endoscope device according to a modified example of each embodiment of the present invention, viewed from above in a fastened state by a fastening holding means. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0021] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0022] Fig. 1 is a side view showing a state in which a procedure is performed using an endoscopic device according to a first embodiment of the present invention. As shown in Fig. 1, the endoscopic device 1 is a spinal endoscope device used for the treatment (including surgery) of spinal disorders such as herniated discs and spinal stenosis. A flexible arm 11 extends from an operating table (not shown) or nearby.

[0023] Fig. 2 is a perspective view of the retractor of the endoscopic device in Fig. 1 as seen obliquely from the front, and Fig. 3 is a perspective view of the retractor of the endoscopic device in Fig. 1 as seen obliquely from above. As shown in Figs. 2 and 3, the endoscopic device 1 is equipped with a retractor 2.

[0024] The retractor 2 has a generally cylindrical tubular portion 21 that is inserted into the body of the patient X. The tubular portion 21 is made of a metal such as stainless steel, and when inserted into the body, it secures a tubular insertion space through which an endoscope and surgical tools (not shown) are inserted. At this time, a surgical tool such as a drill may also be inserted.

[0025] A spherical portion 22 having a spherical outer peripheral surface is provided on the outer periphery of the cylindrical portion 21 of the retractor 2. This spherical portion 22 is provided at a lower position on the outer peripheral surface of an insertion member 20 having a substantially circular insertion hole 23 through which the cylindrical portion 21 is inserted. The insertion member 20 is made of metal such as stainless steel. The spherical portion 22 is formed in a shape in which both ends in the axial direction passing through the center of the sphere are cut out by parallel flat surfaces. The cylindrical portion 21 is inserted into the insertion hole 23 passing through the center of the spherical portion 22 from one side in the axial direction (the upper side in Figures 2 and 3). The peripheral surface of the insertion hole 23 of the insertion member 20 and the outer peripheral surface of the cylindrical portion 21 are substantially coincident.

[0026] Furthermore, a support member 3 that supports the tubular portion 21 of the retractor 2 is supported on the other end of the flexible arm 11. The support member 3 includes a pair of first and second support arms 31, 32, and the other end of the first support arm 31 is attached to the other end of the flexible arm 11. One ends of the first and second support arms 31, 32 are connected to each other via a hinge 33 as a connecting portion. Concave spherical support bearing surfaces 34, 34 that are formed into a substantially semicircular arc shape are provided on one end sides of the first and second support arms 31, 32 so as to sandwich almost the entire outer circumferential area of ​​the spherical portion 22 from one point in the circumferential direction via the hinge 33.

[0027] Fig. 4 shows a plan view of the retractor 2 in Fig. 2 as seen from above in a fastened state by the fastening and holding means. As also shown in Fig. 4, the support member 3 is provided with fastening and holding means 4 that fastens the other end sides (right end sides in Fig. 4) of the support arms 31, 32 away from the hinges 33 together in the mutual approach and separation direction (up and down direction in Fig. 4). The fastening and holding means 4 is provided with a screw member 40 having screw portions 41, 42 on the distal end side and proximal end side in the axial direction, respectively.

[0028] The other end of the first support arm 31 is provided with a threaded hole 35 into which the screw portion 41 is screwed. On the other hand, the other end of the second support arm 32 is provided with an insertion hole 36 having a larger diameter than the screw portion 41. A gap S is generated between the other ends of the first and second support arms 31, 32 when the screw portion 41 is threadedly attached to the first support arm 31 through the insertion hole 36 of the second support arm 32. This gap S holds the support bearing surfaces 34, 34 of the support arms 31, 32 in a state where they can slide around the center of the spherical portion 22 and cannot be separated from each other.

[0029] Fig. 5 shows a plan view of the retractor 2 of Fig. 4 seen from above in a crimped state by the elastic crimping means. As shown in Fig. 5, the support member 3 is provided with elastic crimping means 43 that applies elastic force to the other ends of the support arms 31, 32 fastened by the fastening and holding means 4 in a direction that brings them closer to each other. The elastic crimping means 43 includes a manually fastenable ring-shaped screw member 44 that is screwed onto the threaded portion 42 on the base end side of the screw member 40, and a coil spring 45 as a spring member that is compressed between the screw member 44 and the other end of the second support arm 32. At this time, the other end of the second support arm 32 is pressed toward the other end of the first support arm 31 by the coil spring 45 that is compressed by the tightening of the screw member 44, and the support bearing surfaces 34, 34 are crimped in a state in which the sliding resistance against the spherical portion 22 is adjusted in accordance with the tightening or loosening of the screw member 44.

[0030] Fig. 6 is a plan view seen from above of the state before the engagement between the tubular portion 21 of the retractor 2 and the inserting member 20 in Fig. 2, and Fig. 7 is a side view seen from the side of the state before the engagement between the tubular portion 21 of the retractor 2 and the inserting member 20 in Fig. 2. Also, Fig. 8 is a plan view seen from above of the state after the engagement between the tubular portion 21 of the retractor 2 and the inserting member 20 in Fig. 2.

[0031] 6 to 8, an engaging means 5 is provided between the rear end position in the insertion direction of the outer peripheral surface of the tubular portion 21 and the rear end position in the insertion direction of the peripheral surface of the insertion hole 23 of the inserting member 20 through which the tubular portion 21 is inserted, for disengaging and engaging the tubular portion 21, 20 with the tubular portion 21 inserted into the insertion hole 23. The engaging means 5 includes an arc-shaped protrusion 51 protruding from a single location on the outer peripheral surface of the tubular portion 21 at the rear end position in the insertion direction of the tubular portion 21, and a recessed portion 52 recessed into the rear end position in the insertion direction of the peripheral surface of the insertion hole 23. The recessed portion 52 extends from the rear end in the insertion direction of the peripheral surface of the insertion hole 23 in the axial direction of the tubular portion 21, allowing the protrusion 51 to move in the axial direction.

[0032] The engaging means 5 also includes a groove 53 recessed at a communication position communicating with the recess 52, i.e., from the recess 52, along the circumferential surface of the insertion hole 23 toward one circumferential side (clockwise in FIGS. 6 and 8) over a range of approximately 150°. When the tubular portion 21 is inserted, the protrusion 51 passes through the recess 52 and moves toward the one circumferential side along the groove 53. The groove 53 gradually becomes shallower as it approaches the terminal position on the one circumferential side from the recess 52.

[0033] Therefore, in this embodiment, the other ends of the support arms 31, 32 are fastened together in the direction of contact so that the support seats 34 are held in an inseparable state while being slidable around the center of the spherical portion 22, and elastic force in the direction of approaching each other is applied by manually tightening and loosening the coil spring 45, so that the support seats 34 are pressed together in a state in which the sliding resistance is adjusted against the spherical portion 22. As a result, even during treatment, the angle of the tubular portion 21 can be changed simply by sliding the support seats 34 against the elastic force against the spherical portion 22 without loosening the coil spring 45, thereby easily adjusting the retractor 2 during treatment and allowing for smooth treatment.

[0034] Furthermore, the projections 51 on the outer peripheral surface of the tubular portion 21 are moved by the recesses 52 in the axial direction from the rear end in the insertion direction of the peripheral surface of the insertion hole 23, and the grooves 53, which move in the circumferential direction along the insertion hole 23 from the communicating position with the recesses 52, become shallower as they move away from each other in the circumferential direction, and by this engagement means 5, the tubular portion 21 and the insertion hole 23 are releasably engaged with each other while the tubular portion 21 is inserted into the insertion hole 23. This allows the tubular portion 21 to be engaged with and disengaged from the insertion hole 23 with a simple configuration, and it is possible to replace only the tubular portion 21, thereby reducing the replacement cost of the retractor 2.

[0035] In the first embodiment, the coil spring 45 is compressed between the screw member 44 and the other end of the second support arm 32, but as shown in Fig. 9, a trapezoidal spring 46 may be used as the spring member. In this case, a cylindrical boss portion 47 is provided on the screw member 44, and the trapezoidal spring 46 has a larger diameter than the threaded portion 42 of the screw member 40, so that the trapezoidal spring 46 is not crushed when the screw member 44 is tightened, and the screw member 44 can be tightened smoothly.

[0036] Next, a second embodiment of the present invention will be described with reference to FIG.

[0037] In this embodiment, the configuration of the engaging means is changed. Note that the configuration other than the engaging means is the same as in the first embodiment, and the same parts are given the same reference numerals and detailed explanations thereof will be omitted.

[0038] FIG. 10 is an explanatory diagram illustrating the mutual engagement state of the cylindrical portion of the retractor and the insertion member of the endoscope device according to the second embodiment of the present invention, as viewed from above.

[0039] 10, the engaging means 6 includes a generally arc-shaped projection 61 protruding from a single location on the outer circumferential surface at the rear end position in the insertion direction of the tubular portion 21 (a position on the near side of the paper in FIG. 10), and a recess 62 recessed into the rear end position in the insertion direction of the circumferential surface of the insertion hole 23. The recess 62 extends from the rear end in the insertion direction of the circumferential surface of the insertion hole 23 in the axial direction of the tubular portion 21, and enables the projection 61 to move in the axial direction.

[0040] The engagement means 6 also has a groove 63 recessed at a communication position communicating with the recess 62, i.e., from the recess 62 along the circumferential surface of the insertion hole 23 to one circumferential side (clockwise in FIG. 10) over a range of approximately 90°. The protrusion 61 passes through the recess 62 and moves to one circumferential side along the groove 63 when the tubular portion 21 is inserted. The engagement means 6 also has a protrusion accommodating hole 64 provided at an end position (the position of the protrusion 61 shown by the two-dot chain line in FIG. 10) that is the separation position of the groove 63 that is separated from the recess 62 to one circumferential side.

[0041] Furthermore, the engagement means 6 includes a climbing portion 65 provided at a position (the position of the protrusion 61 shown by the dashed line in FIG. 10) near the recess of the groove 63, which is located near the recess 62 on the other circumferential side (counterclockwise in FIG. 10) of the protrusion accommodating hole 64. This climbing portion 65 is adjusted so that the depth of the groove 63 becomes slightly shallower toward the protrusion accommodating hole 64, allowing the protrusion 61 to climb over it toward the protrusion accommodating hole 64. Then, the protrusion 61 moving in the groove 63 toward one circumferential side climbs over the climbing portion 65 and engages with the protrusion accommodating hole 64 at its terminal position in a state where it is accommodated therein and unable to move circumferentially.

[0042] Therefore, in this embodiment, when the protrusion 61 of the tubular portion 21 is moved further in the circumferential direction from the rear end in the insertion direction of the peripheral surface of the insertion hole 23, through the recess 62, and from the communicating position past the terminal position of the groove portion 63, it engages with the protrusion accommodating hole 64 so as to be unable to move in the circumferential direction. This allows the tubular portion 21 to be engaged with and disengaged from the insertion hole 23 with a simple configuration, and enables replacement of only the tubular portion 21, thereby reducing the replacement cost of the retractor 2.

[0043] Furthermore, the protrusion 61 moving circumferentially in the groove portion 63 overcomes the overhanging portion 65 and engages with the protrusion accommodating hole 64 at the terminal position so as to be unable to move circumferentially, thereby reliably preventing the tubular portion 21 from falling out of the insertion hole 23.

[0044] Next, a third embodiment of the present invention will be described with reference to FIGS.

[0045] In this embodiment, the configuration of the engaging means is changed. Note that the configuration other than the engaging means is the same as in the first embodiment, and the same parts are given the same reference numerals and detailed explanations thereof will be omitted.

[0046] Fig. 11 shows an exploded perspective view of the retractor 2 of the endoscopic device 1 according to the third embodiment of the present invention, with (a) showing a perspective view of the tubular portion 21 and (b) showing a perspective view of the inserting member 20. Fig. 12 shows a plan view from above of the state before the tubular portion 21 of the retractor 2 in Fig. 11 is engaged with the inserting member 20. Fig. 13 shows a plan view from above of the state after the tubular portion 21 of the retractor 2 in Fig. 11 is engaged with the inserting member 20, and Fig. 14 shows a side view of the state after the tubular portion 21 of the retractor 2 in Fig. 11 is engaged with the inserting member 20, as seen from the side.

[0047] 11, the engaging means 7 includes a generally arc-shaped projection 71 protruding from a single location on the outer peripheral surface at the rear end position in the insertion direction of the tubular portion 21 (the upper end position in FIG. 11), and cutout pieces 72 cut out in the axial direction from the rear end in the insertion direction of the tubular portion 21 (the upper end in FIG. 11) on both circumferential sides of the projection 71. The cutout pieces 72 are provided with bent portions 73 that are slightly bent radially outward at their axial tips (the upper end in FIG. 11).

[0048] 12 to 14, the engaging means 7 is provided with a recess 74 recessed at the rear end position in the insertion direction of the circumferential surface of the insertion hole 23, which opens at a position slightly eccentric with respect to the inserting member 20. The recess 74 extends from the rear end of the inserting member 20 in the insertion direction toward the axial direction of the tubular portion 21, allowing the protrusion 71 to move in the axial direction. The engaging means 7 is also provided with a groove 75 recessed at a communication position that communicates with the recess 74, i.e., a groove 75 that is recessed from the recess 74 along the entire circumferential surface of the insertion hole 23. When the tubular portion 21 is inserted into the insertion hole 23, only the protrusion 71 passes through the recess 74 and moves toward one side in the circumferential direction along the groove 75. At this time, the tip of the bent portion 73 of the cutout piece 72 is located toward the rear end of the insertion direction of the inserting member 20 relative to the groove portion 75, and therefore is in contact with the circumferential surface of the insertion hole 23, and slides toward one side in the circumferential direction along the circumferential surface of the insertion hole 23 together with the protrusion 71 moving in the groove portion 75.

[0049] Furthermore, the engaging means 7 is provided with a bent portion accommodating hole 76 recessed into the insertion hole 23 at a position spaced from the recess 74 at approximately 60° to one circumferential side (clockwise in FIGS. 12 and 14). The bent portion accommodating hole 76 accommodates, so as to be immovable in the circumferential direction, the tip of the bent portion 73 of the cutout piece 72 which slides toward one circumferential side along the circumferential surface of the insertion hole 23 beyond the recess 74 together with the protrusion 71 which moves toward one circumferential side through the groove portion 75 from the position communicating with the recess 74.

[0050] Therefore, in this embodiment, when the protrusion 71, which has been moved in the axial direction by the recess 74 of the insertion hole 23, is moved circumferentially from the communicating position along the groove 75 of the insertion hole 23, the tip of the bent portion 73, which slides on the circumferential surface of the insertion hole 23 along with the protrusion 71, engages with the bent portion accommodating hole 76 so as to be immovable in the circumferential direction at a position separated from the recess 74. This allows the tubular portion 21 to be engaged with and disengaged from the insertion hole 23 with a simple configuration, and reduces the replacement cost of the retractor 2, which allows for replacement of only the tubular portion 21.

[0051] Furthermore, since the tip of the bent portion 73, which slides along the circumferential surface of the insertion hole 23, is engaged with the bent portion accommodating hole 76 so as not to be able to move circumferentially as the protrusion 61 moves to one side in the circumferential direction, it is possible to reliably prevent the tubular portion 21 from falling out of the insertion hole 23.

[0052] It should be noted that the present invention is not limited to the above-described embodiments and includes various other modified examples. For example, in the third embodiment, the peripheral surface of the insertion hole 23 and the outer peripheral surface of the tubular portion 21 are made to substantially coincide with each other. However, as shown in Fig. 15, if the outer diameter of the tubular portion 21 is smaller than that of the insertion hole 23 of the inserting member 20, a substantially arc-shaped spacer 25 may be attached to the outer peripheral surface of the tubular portion 21 to expand the outer diameter of the tubular portion 21 so that the outer diameter substantially coincides with that of the insertion hole 23 of the inserting member 20. In this case, a small-diameter tubular portion 21 having a different diameter from the insertion hole 23 can be attached.

[0053] Furthermore, in each of the above-described embodiments, the elastic force of the coil spring 45 compressed between the screw member 44 screwed onto the screw portion 42 on the base end side of the screw member 40 and the other end side of the second support arm 32 is used, but an elastic force other than that of a coil spring may also be used. Specifically, as shown in Fig. 16, a fastening and holding means 81 is provided with a screw member 83 that is fastened to the threaded hole 35 on the other end side of the first support arm 31 via an insertion hole 36 with a larger diameter than the screw portion 82 in a state in which the screw member 83 can be attached to and detached from the other end side of the second support arm 32 with a gap S therebetween. Meanwhile, the elastic crimping means 84 includes linear slits 85, 85 extending in the longitudinal direction at the other end sides of the support arms 31, 32 and separating from each other as they approach the other ends, a sliding member 86 covering the other ends of the support arms 31, 32 so as to straddle the other ends of the support arms 31, 32 and slidable in the longitudinal direction of the support arms 31, 32, and pin members 87, 87 having base ends fixed to the sliding member 86 and having tip ends inserted into the slits 85, 85 of the support arms 31, 32. As the sliding member 86 slides toward the other ends of the support arms 31, 32, the pin members 87, which separate from each other on the slits 85, 85, bend to generate an elastic force when the support arms 31, 32 are brought closer to each other. In this case, the elastic crimping means 84 can be configured using the existing pin members 87 without providing a new elastic body.

[0054] In the third embodiment, the groove 65 is recessed from the recess 62 to one side in the circumferential direction along the circumferential surface of the insertion hole 23 over a range of approximately 90°, but the groove may be recessed over the entire circumferential direction along the circumferential surface of the insertion hole, in which case it is sufficient that the protrusion accommodating hole is provided at a position away from the recess, and the overhanging portion is provided at a position closer to the recess of the groove that is closer to the recess than the protrusion accommodating hole. Moreover, in the third embodiment, the overhanging portion 65 is adjusted so that the depth of the groove 63 becomes slightly shallower toward the protrusion accommodating hole 64, but the depth of the groove may be adjusted to be even shallower so that the protrusion can easily climb over it.

[0055] Furthermore, in the first embodiment, the coil spring 45 and the trapezoidal spring 46 are used as the spring members, but a disc spring or a leaf spring may also be used.

[0056] Furthermore, in each of the above-described embodiments, the support seats 34, 34 at one end of the first and second support arms 31, 32 are connected by a hinge 33, but the support seats at one end of the first and second support arms may also be connected by a connecting device such as a bolt, and it is sufficient that a concave spherical support seat that sandwiches the spherical portion from the circumferential direction so that the spherical portion can slide around its center over almost the entire circumferential direction is provided at one end of the pair of support arms. [Explanation of symbols]

[0057] 1. Endoscopic device 2 Retractors 20 Insertion member 21 Cylinder part 22 Spherical part 23 Insertion hole 3 Support member 31 First support arm (support arm) 32 Second support arm (support arm) 33 Hinge (connecting member) 34 Support seat 4 Fastening and holding means 40 Screw member 41 Screw part on tip side 42 Threaded portion on the base end 43 Elastic crimping means 44 Threaded parts 45 Coil spring (spring material) 46 Trapezoidal spring (spring component) 5 Engagement means 51 protrusion 52 recess 53 Groove 6 Engagement means 61 protrusion 62 recess 63 Groove 64 Protrusion accommodation hole 65 Overpass 7 Engagement means 71 Protrusion 72 Pieces 73 Bend part 74 recess 75 Groove 76 Bent part accommodation hole 81 Fastening and holding means 82 Screw part 83 Screw parts 84 Elastic crimping means S Gap

Claims

1. An endoscope device that has a retractor that secures a cylindrical insertion space inside a body and has a cylindrical portion through which an endoscope and a surgical tool are inserted, and that makes it possible to observe a surgical field deep inside the body through the retractor, The cylindrical portion of the retractor is provided with a spherical portion having a spherical outer circumferential surface, The support member for supporting the cylindrical portion of the retractor includes: a pair of support arms each having a concave spherical support seat formed in a substantially semicircular arc shape at one end thereof so as to sandwich substantially the entire circumferential area of ​​the spherical portion from one circumferential point via a connecting portion; a fastening means for fastening the other ends of the support arms away from the connecting portion together in the direction of separation and attachment, and for undetachably holding the support seat surfaces in a state in which they can slide around the center of the spherical portion; an elastic pressure-bonding means for applying an elastic force to the other end of each support arm fastened by the fastening holding means in a direction toward each other, and for pressurizing each support seat surface against the spherical portion while adjusting the sliding resistance of each support seat surface so that the angle of the cylindrical portion can be changed simply by sliding each support seat surface against this elastic force; It also has The fastening and holding means is a screw member having a screw portion at a tip end thereof which is fastened to the other support arm through an insertion hole of one of the support arms with a gap between the other end sides of the other support arm; The elastic pressure-bonding means is a screw member that is screwed into the threaded portion on the base end side of the screw member and that can be manually moved from the base end side to the tip end side of the screw member so as to be loosened and fastened; a spring member that is compressed between the screw member and the other end of the one support arm and that is compressed when the screw member is fastened; It is equipped with the spherical portion is provided on an outer peripheral surface of an insertion member having an insertion hole through which the cylindrical portion is inserted, and an engaging means is provided between a rear end position in the insertion direction of the outer peripheral surface of the cylindrical portion and a rear end position in the insertion direction of the peripheral surface of the insertion hole, for detachably engaging the cylindrical portion and the insertion hole while the cylindrical portion is inserted into the insertion hole; The engagement means a protrusion provided on a peripheral surface of the cylindrical portion at a rear end position in the insertion direction; a recess formed in a peripheral surface of the insertion hole at a rear end position in the insertion direction, the recess moving the protrusion from the rear end in the insertion direction in the axial direction of the cylindrical portion; a groove portion recessed in a circumferential direction along a circumferential surface of the insertion hole from a communication position communicating with the recess portion, and allowing the protrusion to move in the circumferential direction; The endoscope device is characterized in that the groove portion is formed so as to become shallower as it moves away from the communicating position with the recessed portion in the circumferential direction.

2. An endoscopic device having a retractor that secures a cylindrical insertion space inside the body and has a cylindrical portion through which an endoscope and surgical tools are inserted, and that makes it possible to observe a surgical field deep inside the body through this retractor, The cylindrical portion of the retractor is provided with a spherical portion having a spherical outer circumferential surface, The support member for supporting the cylindrical portion of the retractor includes: a pair of support arms each having a concave spherical support seat formed in a substantially semicircular arc shape at one end thereof so as to sandwich substantially the entire circumferential area of ​​the spherical portion from one circumferential point via a connecting portion; a fastening means for fastening the other ends of the support arms away from the connecting portion together in the direction of separation and attachment, and for undetachably holding the support seat surfaces in a state in which they can slide around the center of the spherical portion; an elastic pressure-bonding means for applying an elastic force to the other end of each support arm fastened by the fastening holding means in a direction toward each other, and for pressurizing each support seat surface against the spherical portion while adjusting the sliding resistance of each support seat surface so that the angle of the cylindrical portion can be changed simply by sliding each support seat surface against this elastic force; It also has The fastening and holding means is a screw member having a screw portion at a tip end thereof which is fastened to the other support arm through an insertion hole of one of the support arms with a gap between the other end sides of the other support arm; The elastic pressure-bonding means is a screw member that is screwed into the threaded portion on the base end side of the screw member and that can be manually moved from the base end side to the tip end side of the screw member so as to be loosened and fastened; a spring member that is compressed between the screw member and the other end of the one support arm and that is compressed when the screw member is fastened; It is equipped with the spherical portion is provided on an outer peripheral surface of an insertion member having an insertion hole through which the cylindrical portion is inserted, and an engaging means is provided between a rear end position in the insertion direction of the outer peripheral surface of the cylindrical portion and a rear end position in the insertion direction of the peripheral surface of the insertion hole, for detachably engaging the cylindrical portion and the insertion hole while the cylindrical portion is inserted into the insertion hole; The engagement means a protrusion provided on a peripheral surface of the cylindrical portion at a rear end position in the insertion direction; cutouts formed by cutting out both circumferential sides of the protrusion from a rear end of the cylindrical portion in the insertion direction in the axial direction; a bent portion in which the tip of the cutout piece is slightly bent radially outward; a recess formed in a peripheral surface of the insertion hole at a rear end position in the insertion direction, the recess moving the protrusion from the rear end in the insertion direction in the axial direction of the cylindrical portion; a groove portion recessed in a circumferential direction along the circumferential surface of the insertion hole from a communication position communicating with the recess portion, for moving the protrusion in the circumferential direction; and a bent portion accommodating hole recessed in a spaced position on the circumferential surface of the insertion hole spaced from the recess portion in the circumferential direction, for accommodating the bent portion, which slides in the circumferential direction on the circumferential surface of the insertion hole together with the protrusion moving in the groove portion, so as to be immovable in the circumferential direction; The endoscope apparatus according to claim 1, further comprising:

3. An endoscopic device having a retractor that secures a cylindrical insertion space inside the body and has a cylindrical portion through which an endoscope and surgical tools are inserted, and that makes it possible to observe a surgical field deep inside the body through this retractor, The cylindrical portion of the retractor is provided with a spherical portion having a spherical outer circumferential surface, The support member for supporting the cylindrical portion of the retractor includes: a pair of support arms each having a concave spherical support seat formed in a substantially semicircular arc shape at one end thereof so as to sandwich substantially the entire circumferential area of ​​the spherical portion from one circumferential point via a connecting portion; a fastening means for fastening the other ends of the support arms away from the connecting portion together in the direction of separation and attachment, and for undetachably holding the support seat surfaces in a state in which they can slide around the center of the spherical portion; an elastic pressure-bonding means for applying an elastic force to the other end of each support arm fastened by the fastening holding means in a direction toward each other, and for pressurizing each support seat surface against the spherical portion while adjusting the sliding resistance of each support seat surface so that the angle of the cylindrical portion can be changed simply by sliding each support seat surface against this elastic force; It also has The fastening and holding means is a screw member having a screw portion at a tip end thereof which is fastened to the other support arm through an insertion hole of one of the support arms with a gap between the other end sides of the other support arm; The elastic pressure-bonding means is a screw member that is screwed into the threaded portion on the base end side of the screw member and that can be manually moved from the base end side to the tip end side of the screw member so as to be loosened and fastened; a spring member that is compressed between the screw member and the other end of the one support arm and that is compressed when the screw member is fastened; It is equipped with the spherical portion is provided on an outer peripheral surface of an insertion member having an insertion hole through which the cylindrical portion is inserted, and an engaging means is provided between a rear end position in the insertion direction of the outer peripheral surface of the cylindrical portion and a rear end position in the insertion direction of the peripheral surface of the insertion hole, for detachably engaging the cylindrical portion and the insertion hole while the cylindrical portion is inserted into the insertion hole; The engagement means a protrusion provided on a peripheral surface of the cylindrical portion at a rear end position in the insertion direction; a recess formed in a peripheral surface of the insertion hole at a rear end position in the insertion direction, the recess moving the protrusion from the rear end in the insertion direction in the axial direction of the cylindrical portion; a groove portion recessed in a circumferential direction along a circumferential surface of the insertion hole from a communication position communicating with the recess portion, the groove portion allowing the protrusion to move in the circumferential direction; a projection accommodating hole provided in the groove at a position spaced from the recess, the projection being accommodated in the groove so as to be immovable in a circumferential direction; a crossing portion provided at a position closer to the recess of the groove portion, which is located closer to the recess than the protrusion accommodating hole, and which adjusts the depth of the groove portion so that the protrusion can cross over toward the protrusion accommodating hole; The endoscope apparatus according to claim 1, further comprising:

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